What physical exam finding will be observed in 'Saturday night palsy'?

Correct Answer: A

Rationale: In 'Saturday night palsy,' there is compression or injury to the radial nerve, resulting in weakness or paralysis of the wrist and finger extensor muscles. The correct answer, option A, "Marked wrist and finger drop," directly correlates with this characteristic presentation. This physical exam finding is a hallmark of radial nerve dysfunction. Option B, "Atrophy of abductor pollicis brevis (APB)," is associated with median nerve injury rather than radial nerve dysfunction seen in 'Saturday night palsy.' Option C, "Weak elbow extension," typically points to a different nerve involvement, such as the musculocutaneous nerve. Option D, "Painless weakness and atrophy of hand intrinsic muscle," does not align with the typical presentation of 'Saturday night palsy,' which is characterized by weakness in the wrist and finger extensors. Educationally, understanding specific physical exam findings associated with nerve injuries is crucial for accurate clinical assessments. Recognizing these patterns aids in localizing the nerve injury and determining appropriate management strategies. This knowledge is particularly important for healthcare professionals involved in diagnosing and treating patients with neurological conditions or injuries.

Correct Answer: C

Rationale: In the context of vital signs assessment, the correct answer is C) Diagnostic hypothesis. A nurse uses diagnostic reasoning to formulate a diagnostic hypothesis based on the data gathered from the vital signs assessment. This involves analyzing the information collected, identifying patterns or abnormalities, and formulating a tentative conclusion about the potential health issue or condition the patient may be experiencing. Option A) Nursing diagnosis is incorrect because it refers to the identification and labeling of a patient's actual or potential response to a health problem, which comes after the diagnostic process. Option B) Medical diagnosis is also incorrect as it is the identification of a disease or condition based on specific signs, symptoms, and diagnostic tests conducted by a physician. Option D) Diagnostic assessment is not the most appropriate answer as it refers to the process of evaluating a patient's health status through various assessments and tests but does not involve the formulation of a diagnostic hypothesis. Educationally, understanding the distinction between nursing diagnosis, medical diagnosis, diagnostic hypothesis, and diagnostic assessment is crucial for nurses to effectively assess, plan, and implement patient care. Developing strong diagnostic reasoning skills enables nurses to make informed decisions, prioritize interventions, and collaborate with healthcare team members to provide holistic and individualized care to patients.

Correct Answer: D

Rationale: The correct answer is D) Dashboard injury. A Dashboard injury occurs when a person's bent knee forcefully impacts a hard surface, such as in a car accident where the knee hits the dashboard. This mechanism of injury places significant stress on the posterior aspect of the knee, leading to a posterior cruciate ligament (PCL) injury. Option A) Hyperextension of the knee is not the most common cause of PCL injury. While hyperextension can cause PCL injury, it is less common than a Dashboard injury. Option B) Rotation of the femur on a fixed lower leg is more associated with anterior cruciate ligament (ACL) injuries rather than PCL injuries. Option C) Hyperflexion of the knee is not a common cause of PCL injury. PCL injuries are more likely to occur with hyperextension or posteriorly directed forces on the knee. In an educational context, understanding the common mechanisms of injury for ligament damage is crucial for healthcare professionals, especially those involved in sports medicine or orthopedics. Knowing the typical causes of PCL injuries helps in accurate diagnosis and appropriate treatment planning for patients. Additionally, this knowledge aids in preventive strategies and patient education to reduce the risk of such injuries.

Correct Answer: A

Rationale: In the field of ophthalmology, understanding the anatomy of the eye is crucial for assessing vision and eye health. In the context of vital signs assessment, knowledge of ocular structures is important for detecting potential vision problems that may impact a patient's overall health. The correct answer is A) The fovea. The fovea is the central focal point for incoming images in the eye. It is located in the center of the macula and is responsible for sharp central vision and color perception. This area has the highest concentration of cone cells, which are essential for detailed vision. Option B) The macula is incorrect because while it surrounds the fovea and is important for central vision, the fovea itself is the specific central focal point for incoming images. Option C) The optic disk is incorrect as it is the area where the optic nerve exits the eye, and it lacks photoreceptor cells, making it a blind spot in the visual field. Option D) The physiologic cup is a small depression in the optic nerve head and is not the central focal point for incoming images. Educationally, understanding the significance of the fovea in visual acuity and the role it plays in central vision highlights the precision and complexity of the eye's anatomy. This knowledge is essential for healthcare professionals to accurately assess and address visual impairments or abnormalities in patients during vital signs assessments.

Correct Answer: C

Rationale: A liver edge palpable this far below the costal arch should not be ignored. Ultrasound and laboratory investigation are reasonable if the liver is actually enlarged. Mr. Patel has developed emphysema with flattening of the diaphragms. This pushes a normal-sized liver below the costal arch so that it appears to be enlarged. A liver span should be determined by percussing down the chest wall until dullness is heard. A measurement is then made between this point and the lower border of the liver to determine its span; 6–12 centimeters in the mid-clavicular line is normal. Percussion is the only way to assess liver size on examination, and in this case it saved the patient much inconvenience and expense.